Provider Demographics
NPI:1437727401
Name:CHOSEN CARE HOSPICE LLC
Entity Type:Organization
Organization Name:CHOSEN CARE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QAPI COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:AQUINO
Authorized Official - Last Name:DESIDERIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:951-268-6533
Mailing Address - Street 1:1451 RIMPAU AVE STE 213
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-7522
Mailing Address - Country:US
Mailing Address - Phone:951-268-5333
Mailing Address - Fax:
Practice Address - Street 1:1451 RIMPAU AVE STE 213
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-7522
Practice Address - Country:US
Practice Address - Phone:951-268-5333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based